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Children are largely unaffected by COVID-19 infection, remaining disease-free or manifesting few or mild clinical signs and symptoms. Understanding how the infection affects children is critical to preventing the further spread of the disease. A recent study explored the characteristics and transmission patterns of COVID-19 among children in China.

The study involved more than 2,000 children (average age, 7 years) living in mainland China who had been diagnosed with COVID-19. Children were classified as asymptomatic, mild, moderate, severe, or critical cases, based on diagnostic criteria that included fever, upper or lower respiratory involvement, diarrhea, and other symptoms.

Approximately 4 percent of the children with COVID-19 were asymptomatic, and 51 percent and 38 percent were mild or moderate cases, respectively. Among children manifesting symptoms of the disease, only 5 percent had shortness of breath and fewer than 1 percent progressed to acute respiratory distress syndrome (ARDS) or multiorgan system dysfunction (MODS). These figures are in stark contrast to those observed in adults, where shortness of breath, ARDS, and MODS are far more common, especially in older adults.

The data also indicated that children younger than one year old were at greatest risk of COVID-19 complications. A commentary on the study’s findings suggested that children who had pre-existing respiratory problems or were immunocompromised were also at greater risk. These findings underscore the need for further research into how COVID-19 manifests in younger patients to improve treatment and prevent disease spread.

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